Author: Terry Rondberg

Statin use in postmenopausal women associated with increased diabetes risk

According to the AARP, one in four Americans over age 45 takes a statin drug to lower their cholesterol, but a study published by the Archives of Internal Medicine says the popular medication may increase the risk of diabetes.

Using data through 2005, Annie L. Culver, B. Pharm., Rochester Methodist Hospital, Mayo Clinic, Rochester, Minn., and colleagues analyzed records from the national, multi-year Women’s Health Initiative (WHI). 153,840 women without diabetes and with a mean (average) age of 63.2 years were included. Statin use was assessed at enrollment and in year three. At baseline, 7.04% of women reported taking statins.

The results indicate 10,242 new cases of diabetes and statin use at baseline was associated with an increased risk of diabetes. This association remained after adjusting for other potential variables, including age, race/ethnicity and body mass index, and was observed for all types of statins.

“The results of this study imply that statin use conveys an increased risk of new-onset DM in postmenopausal woman. In keeping with the findings of other studies, our results suggest that statin-induced DM is a medication class effect and not related to potency or to individual statin,” the researchers write.

Not surprisingly, the medical community quickly maintained the results of the study shouldn’t prevent people from taking such drugs, which generate more than $20 billion in sales annually. Quoted in an AP report, Dr. Steven Nissen, cardiology chairman at the Cleveland Clinic, said: “What I fear here is that people who need and will benefit from statins will be scared off of using the drugs because of reports like this.” Nissen was not involved in the research.

The double standard between medical treatment and alternative care is glaringly obvious in such cases. While the medical industry tries to use the one-in-a-million negative response to spinal adjustments as an excuse not to use chiropractic, it urges the public to virtually ignore scientific research on proven risks and side effects of drugs and surgery.

It’s a noisy, noisy, noisy, NOISY world!

We used to associate harmful noise levels with workplaces like factories but it turns out that leisure activities have become even worse.

Researchers at the University of Michigan (UM) found that noise from mp3 players and stereo use causes even more problems than loud work environments, said Rick Neitzel, assistant professor in the UM School of Public Health and the Risk Science Center. Robyn Gershon, a professor with the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco was the principal investigator on the study.

This proved true even though mp3 player and stereo listening made up just a small fraction of each person’s total annual noise exposure. Neitzel said he was surprised by the findings. As an occupational hygienist, he expected regular users of trains and buses along with work-related activities to be the chief culprits in excessive noise exposure.

The study’s authors found that one in 10 transit users had noise exposures exceeding the recommended limits from transit use alone. But when they estimated the total annual exposure from all sources, 90% of transit users and 87% of nonusers exceeded the recommended limits, primarily due to mp33 and stereo usage.

“That two out of three people get the majority of noise exposure from music is pretty striking,” Neitzel said. “I’ve always viewed the workplace as a primary risk for noise exposure. But this would suggest that just focusing our efforts on the workplace isn’t enough, since there’s lots of noise exposure happening elsewhere.”

The implications are startling, said Neitzel.

“I do think it’s a serious problem, there aren’t really any other experiences where we would tolerate having nine out of 10 people exposed at a level we know is hazardous. We certainly wouldn’t tolerate this with another agent, such as something that caused cancer or chronic disease. Yet for some reason we do for noise.”

Initially, the researchers set out to examine the contribution of common noise sources to total annual noise exposures among urban residents for mass transit usage; occupational and non-occupational activities, mp3 player and stereo use; and time at home doing other miscellaneous activities. They looked at what caused the majority of potentially harmful exposures in 4,500 residents in New York City who used public transportation.

With any environmental exposure, until scientists know the length of exposure, the exposure level means nothing. The average New York transit user spends about 380 or so hours either waiting for or riding transit, which has average noise levels of 72-81 decibels. For comparison, the average speaking level is 60 decibels, a busy street corner is 80, a circular saw is 90, a baby crying 115. The threshold for pain is about 125, and even a brief, one-time exposure above that level can cause permanent hearing loss.

“Lots of people appear to be exposed at hazardous levels,” Neitzel said. “A growing number of studies show noise causes stress, sleep disturbance, and heart disease. It may be the noise which we haven’t historically paid much attention to is actually contributing to some of the top health problems in developed countries today. This begs for a public health education program.”

As wellness providers, we’re not really positioned to address this problem directly (although regular chiropractic adjustments can improve a person’s overall health and might provide some protection against hearing loss). However, one indirect measure might be to be mindful of the noise level in our practices. Gentle, soothing music instead of loud radio programs can give patients (and staff members) a break from the constant noise that surrounds them every day. Getting people used to being in a quiet environment may also help them realize they don’t need to have an earphone piping sound into their heads every moment of the day.

Only 14% of hospital medical errors are reported

A new study released in Jan. 2012 by the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) found that hospital employees are only reporting 14% of all medical errors and usually don’t change their practices to prevent future harm to patients.

The study was based on an independent review of patient records. Federal regulations require hospitals to track all medical errors and adverse events that harm patients and to implement preventive measures to protect patients. Only five of the 293 reported cases of medical errors reviewed by federal investigators led to changes in policies or practices by hospitals to prevent harm to patients.

“One in four hospital patients are harmed by medical errors and infections, which translates to about 9 million people each year,” said Lisa McGiffert, director of Consumers Union’s Safe Patient Project. “[This] report confirms what many other studies have already documented. Hospitals are doing a poor job of tracking preventable infections and medical errors and making the changes necessary to keep patients safe. It’s time that hospitals make patient safety a higher priority.”

The OIG report recommends that the Centers for Medicare and Medicaid Services provide hospitals with a standard list of medical errors that should be tracked and reported to the agency. But Consumers Union noted that public reporting of medical errors is critical to driving improvement in patient safety.

“Hospitals should be pushed to do a better job at tracking medical harm, but public reporting is what drives change and the public should have access to this critical information,” said McGiffert. “The solutions arrived at in this report take us down the tired and worn out path of secret reporting of medical harm.”

A 2010 study by the OIG reported that an estimated15,000 Medicare patients experienced medical errors in the hospital that contributed to their deaths each month. That amounts to about 180,000 patients annually. The OIG calculated that Medicare patients harmed during that month required an additional $324 million in hospital care. The study estimated the annual cost for these events in hospital care alone at $4.4 billion.

Young children understand the benefits of positive thinking

Age is supposed to bring wisdom, but sometimes we can learn important life lessons from children.

A study by researchers at Jacksonville University and the University of California, Davis, published in the journal Child Development, showed that even kindergarteners know that thinking positively will make you feel better.

In the study, researchers looked at 90 kids from five to ten years of age. The children listened to six illustrated stories in which two characters feel the same emotion after experiencing something positive (getting a new puppy), negative (spilling milk), or ambiguous (meeting a new teacher).

Following each experience, one character has a separate optimistic thought, framing the event in a positive light, and the other has a separate pessimistic thought, putting the event in a negative light. Researchers described the subsequent thoughts verbally, then asked the children to judge each character’s emotions and provide an explanation for those emotions. They were most interested in the degree to which children predicted different emotions for two characters in the same situation.

Children as young as five predicted that people would feel better after thinking positive thoughts than they would after thinking negative thoughts. They showed the strongest insight about the influence of positive versus negative thoughts on emotions in ambiguous situations. And there was significant development in the children’s understanding about the emotion-feeling link as they grew older.

The researchers gave a similar test to the subject’s parents and found that while the children’s innate level of hope and optimism played a role in their ability to understand the power of positive thinking, their parents’ views on the topic played an even larger part.

“The strongest predictor of children’s knowledge about the benefits of positive thinking – besides age – was not the child’s own level of hope and optimism, but their parents’,” reported Christi Bamford, assistant professor of psychology at Jacksonville University, who led the study when she was at the University of California, Davis.

The findings point to parents’ role in helping children learn how to use positive thinking to feel better when things get tough, Bamford noted. “In short, parents should consider modeling how to look on the bright side.”

Women get reminder about HRT risks

For decades, women were frequently given drugs in a treatment plan dubbed “hormone replacement therapy” (HRT) to relieve symptoms associated with menopause. The demand for HRT treatment declined, as did the incidence of breast cancer in many countries, when, starting in the late 1990s, a series of research reports – including the famed US Women’s Health Initiative (WHI) study of 2002 – linked HRT to osteoporosis, heart disease, stroke, dementia, and breast cancer.

Yet, as soon as the media lost interest in the topic, women (and their doctors) seemed to forget the side effects and risks involved with HRT and prescription rates are creeping up once again.

Hopefully, news of the recent McMaster University research will once more raise the awareness of this dangerous drug intervention. In their study, the McMaster researchers found “convincing evidence” for a direct association between decreased HRT use after the WHI study and the declining incidence of breast cancer. Their research appears in the January 2012 issue of the Journal of Epidemiology and Community Health.

“The evidence is compelling that HRT use increases the risk of breast cancer, and its cessation reduces this risk,” the researchers said.

Dr. Kevin Zbuk, assistant professor of oncology at the Michael G. DeGroote School of Medicine at McMaster and lead author on the study said: “In our study we examined all studies that have reported breast cancer and rates of HRT use after the WHI study. There is very clear evidence that the countries with the highest HRT rates had the largest decrease in breast cancer incidence when HRT use started to decline.

“Given the potential harms associated with HRT use,” Dr. Zbuk continued, “physicians and patients alike should be reminded of the lessons learned from the WHI trial. If HRT is needed, it should be used for the shortest time and at the lowest dose necessary to relieve symptoms.”

Someday, medical researchers will take a really bold step and suggest that such drugs shouldn’t be used at all, or at least only in the rarest of cases. Non-medical approaches such as chiropractic, phytoestrogens, herbal remedies, yoga, energy therapies, and meditation have all been shown to be effective in many women.